Rufus of Ephesus on Sexual Health

On Sexual Activity from the works of Rufus (of Ephesus).

Sex is indeed a natural act, while nothing natural is harmful. But intimacy becomes harmful when it is immoderate and frequent and when it is engaged in at inappropriate times. Frequent intimacy is especially harmful for those who have weakness in the nerve-like parts, such as the chest, kidneys, lower back, hip region, or legs. Here also are some indications [it is harmful]: a person's whole strength becomes weaker during intimacy, but strength is the innate heat within us, hence concoction does not happen as well for those engaging in intercourse, and they become extremely pale and do not see or hear as they should, nor do they have any other strong sensation. Indeed, such people are forgetful and trembling, their joints painful, especially in the hip area; some also develop kidney disease, others have illness in the bladder, some develop thrush-like sores around the mouth, tooth pain, or inflammation of the tonsils; many men ejaculate blood after excessive sexual activity, some due to the violent retention and tension of pneuma, some due to the interaction of the veins and arteries running from the chest to the testicles. Women however ejaculate very little blood during intercourse due to the overall moistness of their bodies, due to the fact that they do not exert themselves as much during intercourse, and due to their regular discharges below, so that even if a woman happens to ejaculate blood, the discharges are a great healing factor for her. For these reasons, the good doctors will recommend that if any of the illnesses mentioned are present or if they are anticipated due to the natural weakness of the person, that they should abstain from sexual activity.

So far, I have spoken about the harms and co-affections (lit. sympathies) of sexual activity, to the extent that as I was able to do so succinctly. Now, we must speak about its benefits. For sexual activity is not always harmful if one takes into consideration the timing, measure, and overall health of the person engaging in intimacy. The benefits of sexual activity are these: to relieve fullness, to provide the body with lightness, to stimulate growth, and to bring about a more manly appearance. And for those in a hardened (tense) state, intimacy at regular intervals is beneficial: it softens (relaxes?) the organs, widens the pores, and removes some phlegm; it breaks up coagulated thoughts and relaxes intense desires. Hence, for a melancholic, depressed, and misanthropic person, sexual intercourse can serve as the most significant and suitable remedy. It can bring to a more moderate state of mind those driven mad in other ways, halt some epileptic symptoms, and relieve those suffering from a weary head and those with pains brought about during puberty. Hippocrates said, in a word, that sexual activity, “is the best remedy for illnesses from phlegm.” Many weakened people have been restored to health from illnesses due to intimacy, with some people’s breathing becoming easier instead of more difficult, and some people's appetite becoming better instead of worse. Some have even been freed from frequent nocturnal emissions. Natures suitable for sexual activity are warmer, more moist, and more actively disposed to intimacy than others, while least suitable are dry and cold; and the nature of those in their prime is right for it, but not the nature of those in their old age.

In terms of seasons, spring is appropriate, while autumn and summer are inappropriate. Winter is not too good either because it is cooling. Moreover, a warmer and moister diet is productive for sexual activity, while a drying and cooling diet is unproductive. Diets suitable for intercourse are appropriate for those who are unable to perform during intercourse. Therefore, the diet should be moist and warm, exertion should be moderate, and food should be plentiful. Wine therefore should be tawny in color and light in body, breads should be freshly baked and pure, meats, of young goats, lambs and pigs, poultry such as hens, thrushes, partridges, geese, and duck; of fish, octopus and whichever are called soft-bodied; of vegetables, sage, erysimon, rocket and turnip that is difficult to cook and has become tender (for these are also given as drugs); of legumes, bean, chick-peas, ochroi, phasiloi, pissoi, and loboi that are full of pneuma and provide plenty of nutrition. I also encourage adding the extremely excellent grape into the current diet; for it moistens and fills the body with blood and pneuma. But someone about to engage in sexual activity must avoid doing it on a full stomach, or with indigestion, drunkenness, or a lack of food. For it is bad to have intercourse when there are residues, one should avoid fatigue from the gym and bath, and recent vomiting and diarrhea from the belly. For these can be chronic when sexual activity causes dryness. The best intercourse happens with food but not after becoming full. For it contributes to strength and the chilling that occurs become less. If someone eagerly desires sex after breakfast, they should wait until the food settles; but if after dinner, it is necessary to sleep for a while. I do not encourage intense desires, and I rather recommend one resist them, especially those for whom it is an illness and are easily harmed by intimacy.

Περὶ ἀφροδισίων ἐκ τῶν Ῥούφου. Φυσικὸν μὲν ἔργον ἡ συνουσία ἐστίν, οὐδὲν δὲ τῶν φυσικῶν βλαβερόν· παρὰ δὲ τὴν ἄμετρόν τε καὶ συνεχῆ χρῆσιν καὶ κατὰ καιρὸν τὸν οὐ προσήκοντα παραλαμβανομένη βλαβερὰ γίγνεται, πολλῷ δὲ μᾶλλον βλαβερὰ ἡ συνεχὴς χρῆσις γίγνεται τοῖς τὸ νευρῶδες ἀσθενὲς ἔχουσιν ἢ θώρακα ἢ νεφροὺς ἢ ὀσφὺν ἢ ἰσχιάδα ἢ πόδας. ἔστω δέ σοι τεκμήρια καὶ τάδε· σύμπασα γὰρ ἡ ἰσχὺς τοῦ ἀνθρώπου ἀσθενεστέρα γίγνεται ἐν τῇ χρήσει· ἡ δὲ ἰσχύς ἐστι τὸ ἐν ἡμῖν ἔμφυτον θερμόν· ὅθεν αἱ πέψεις οὐκ ἀγαθαὶ τῷ μισγομένῳ καὶ ἔξωχροι γίγνονται καὶ οὔτε δεόντως ὁρῶσιν οὔτε ἀκούουσιν, ὡς χρή, οὐδὲ ἄλλην τινὰ αἴσθησιν ἐρρωμένην κέκτηνται καὶ μὲν δὴ καὶ ἐπιλήσμονες οἱ τοιοῦτοι καὶ τρομώδεις εἰσὶ καὶ τὰ ἄρθρα ὀδυνηροί, μάλιστα τὰ τῶν ἰσχίων, καὶ οἱ μὲν νεφριτικοὶ γίγνονται, οἱ δὲ καὶ κατὰ κύστιν νόσημα ἔχουσιν, τοῖς δὲ καὶ στόματα ἀφθώδη γίγνεται καὶ ὀδόντων πόνοι καὶ γαργαρεώνων φλεγμοναί· πολλοὶ δὲ ἄνδρες ἐπὶ τοῖς πολλοῖς ἀφροδισίοις καὶ αἷμα ἔπτυσαν, τὸ μέν τι τῇ βιαίῳ κατοχῇ τε καὶ ἐντάσει τοῦ πνεύματος, τὸ δέ τι τῇ κοινωνίᾳ τῶν ἀπὸ τοῦ θώρακος ἐπὶ τοὺς ὄρχεις φερομένων φλεβῶν καὶ ἀρτηριῶν. γυνὴ δὲ ἥκιστα ἐπὶ ταῖς μίξεσι πτύει αἷμα τῇ τε ἄλλῃ τοῦ σώματος ὑγρότητι καὶ τῷ ἧσσον πονεῖσθαι ἐν τῇ μίξει, καὶ διὰ τὰς εἰωθυίας κάτω καθάρσεις, ὥστε κἂν τύχῃ γυναῖκα πτύσαι αἷμα, μέγα ἴαμα αἱ καθάρσεις αὐτῇ γίγνονται. διὰ ταῦτα μὲν δὴ τὰ εἰρημένα παρακελεύονται τῶν ἰατρῶν οἱ ἀγαθοί, ἤν τε πάρεστι τι τῶν εἰρημένων νοσημάτων, ἤν τε προσδόκιμον ᾖ διὰ τὴν φυσικὴν ἀσθένειαν τοῦ ἀνθρώπου, ἀπέχεσθαι τῶν ἀφροδισίων.

ἄχρι μὲν δὴ τούτων τὰς βλάβας καὶ τὰς συμπαθείας, ἐφ' ὅσον δυνατὸν ἦν ἡμῖν διὰ βραχέων εἰπεῖν, εἰρήκαμεν· ῥητέον δὲ νῦν καὶ τὰς ὠφελείας· οὐ γὰρ παντάπασι κάκιστα τὰ ἀφροδίσιά ἐστιν, ἐὰν καὶ τὸν καιρὸν τῆς χρήσεως καὶ τὸ μέτρον καὶ τὴν ὑγιεινὴν κατάστασιν τοῦ χρωμένου σκοπεῖν ἐθέλοις. ὠφέλειαι δὲ αἱ ἐκ τῶν ἀφροδισίων εἰσὶν αἵδε· πλησμονήν τε κενῶσαι καὶ ἐλαφρὸν παρασχεῖν τὸ σῶμα καὶ εἰς αὔξησιν προτρέψαι καὶ ἀνδρωδέστερον ἀποφῆναι. καὶ τῇ δὲ σκληρᾷ ἕξει ἐκ διαλειμμάτων πλειόνων ἡ χρῆσις ὠφέλιμος· μαλάσσει γὰρ τὰ ὄργανα καὶ ἀνευρύνει τοὺς πόρους καί τι τοῦ φλέγματος ἐκκαθαίρει, καὶ συνεστηκότα δὲ λογισμὸν διαλύει καὶ ὀργὰς μεγίστας ἐπανίησι. διὸ καὶ τῷ μελαγχολικῷ καὶ κατηφεῖ καὶ μισανθρώπῳ ὄντι ὥς τι μέγιστον ἴαμα ἐπιτηδειότατον μίσγεσθαι. καθίστησι δ' εἰς τὸ σωφρονέστερον καὶ τοὺς κατ' ἄλλον τρόπον ἐκμανέντας καί τινας ἐπιλήπτους ἔπαυσε καὶ βαρυνομένους τὴν κεφαλὴν καὶ ἀλγοῦντας μεταβολῇ τοῦ ἡβάσκειν. Ἱπποκράτης δὲ ἑνὶ λόγῳ “τοῖς ἀπὸ φλέγματος νοσήμασιν εἶναι κράτιστα” ἀφροδίσια ἔφη. πολλοὶ δὲ καὶ ἐκ νόσων ἄτροφοι ἀνεκομίσθησαν ἐπὶ τῇ χρήσει· οἱ δὲ καὶ εὐπνούστεροι ἀντὶ δυσπνουστέρων ἐγένοντο, καὶ εὐσιτότεροι ἀντὶ ἀποσίτων· οἱ δὲ καὶ ὀνειρωγμῶν συνεχῶν ἀπηλλάγησαν. φύσεις δὲ πρὸς ἀφροδίσια ἐπιτήδειοι αἱ θερμότεραι καὶ ὑγρότεραι καὶ πλέον τῶν ἄλλων εἰς τὴν χρῆσιν εὔφοροι, ἥκιστα δὲ αἱ ξηραὶ καὶ ψυχραὶ καὶ ἡ μὲν τῶν ἀκμαζόντων εὔθετος, ἡ δὲ τῶν γερόντων οὐδαμῶς.

ὥρα δὲ τὸ μὲν ἔαρ ἐπιτήδειον. ἄθετον δὲ τὸ φθινόπωρον καὶ τὸ θέρος. ἀλλ' οὐδὲ ὁ χειμών ἐστιν ἀγαθὸς τῷ ψύχειν. καὶ δὴ καὶ δίαιτα ἡ θερμοτέρα καὶ ὑγροτέρα εἰς λαγνείαν εὔφορος, δύσφορος δὲ ἡ ξηραίνουσα καὶ ψύχουσα. αἱ γὰρ δίαιται πρὸς μίξεις τῷ ἀδυνάτῳ μίσγεσθαι ἐπιτήδειοι. χρὴ τοίνυν τὴν μὲν δίαιταν ὑγρὰν καὶ θερμὴν ὑπάρχειν· εἴη δ' ἂν πόνων μὲν μετριότης καὶ σίτου εὐωχία. οἶνος μὲν οὖν ἔστω κιρρὸς τῇ χροιᾷ, λεπτὸς δὲ τῇ συστάσει, ἄρτοι καθαροὶ ἰπνῖται πρόσφατοι, κρέα ἐρίφων καὶ ἀρνῶν καὶ χοίρων, πτηνὰ ἀλεκτορίδες ἀτταγῆνες πέρδικες χῆνες νῆσσαι· ἰχθύων δὲ οἱ πολύποδες καὶ ὅσα μαλακόσαρκα λέγεται· λαχάνων δὲ ὅρμινον ἐρύσιμον εὔζωμον γογγυλὶς δύσεφθος καὶ τακερὰ γενομένη (ταῦτα γὰρ καὶ ὡς φάρμακα δίδοται), ὀσπρίων δὲ κύαμοι ἐρέβινθοι ὦχροι φάσιλοι πισσοὶ λοβοὶ πνεύματός τε ἐμπιπλῶντες καὶ ἀφθονίαν τροφῆς παρασκευάζοντες. μεγάλως δὲ ἐπαινῶ καὶ τὴν καλλίστην σταφυλὴν εἰς τὴν νῦν δίαιταν· ὑγραίνει γὰρ καὶ αἵματος καὶ πνεύματος ἐμπίπλησι τὸ σῶμα. τὸν δὲ μέλλοντα ἀφροδισίοις χρῆσθαι πλησμονὰς προσφάτους φυλάττεσθαι χρὴ καὶ ἀπεψίας καὶ μέθας καὶ ἐνδείας. κακὸν γὰρ ἐπὶ περιττώμασι μίσγεσθαι καὶ ἀπὸ γυμνασίων καὶ λουτρῶν καὶ κόπους δὲ φυλακτέον καὶ ἐμέτους γεγενημένους καὶ διαρροίας γαστρὸς προσφάτους. τὰς γὰρ χρονίους ἐστὶν ὅτε ξηραίνει τὰ ἀφροδίσια. κάλλιστον δὲ τὸν μισγόμενον ἐπὶ σίτοις μίσγεσθαι μὴ ἐμπλησθέντα· καὶ γὰρ πρὸς ἰσχὺν συμφέρει καὶ αἱ γιγνόμεναι ψύξεις ἧσσον γίγνονται καὶ εἰ μὲν ἐπὶ τῷ ἀρίστῳ τις προθυμηθείη, ἀναπαύσασθαι χρὴ μέχρι καταστῇ τὸ σιτίον, εἰ δὲ ἐπὶ τῷ δείπνῳ ὑπνοῦν ἀνάγκη πρὸς ὀλίγον. καὶ τὰς σφοδρὰς δὲ ἐπιθυμίας οὐκ ἐπαινῶ ἀλλὰ κελεύω δὴ πλέον ἀντέχειν καὶ μᾶλλον οἷς νόσημά ἐστι ῥᾷον ἐκ τῆς χρήσεως βλαπτόμενον.

Rufus of Ephesus, quoted in Aetius of Amida, Medical Books, 3.8, 265,13–268,12 Olivieri

Also in Daremberg’s Oeuvres de Rufus d'Ephèse, pp. 318–325

Holding it in

“You can learn for yourself what I’m saying is true if you consider something that often happens to people. There are times when a biting humour builds up in the area around the anus and it makes us really need to go to the bathroom, but we are forced to hold it in because we are in the middle of some public business; once we’re done with it, we can’t go to the bathroom anymore and as a result we often we also get a headache and an upset stomach.”

ὅτι δὲ ἀληθές ἐστιν ὃ λέγω, πάρεστι μαθεῖν ἑκάστῳ τῶν πολλάκις ἡμῖν συμβαινόντων ἀναμνησθέντι. δακνώδης γοῦν ἐνίοτε χυμὸς εἰς τὰ κατὰ τὴν ἕδραν χωρία παραγενόμενος, ἐρεθίζει μὲν ἡμᾶς ἐπὶ τὴν ἔκκρισιν αὐτοῦ· κατασχεῖν δὲ αὐτὸν ἀναγκασθέντες, ἐπειδὰν ἐν πολιτικαῖς ὦμεν πράξεσιν, ἀπαλλαγέντες αὐτῶν οὐκέτ' ἀποκρίνομεν, αἰσθανόμεθά τε κἀκ τούτου πολλάκις τῆς κεφαλῆς ὀδυνηρᾶς γινομένης ἀνατρεπομένης τε τῆς γαστρός.

Galen, Matters of Health 6.10, 6.433 K. = 190,1–7 Koch

“For when people really need to poo but because they are held up in the agora or some other unsuitable place they hold it in for a long time, they are either no longer able to poo or their poo is small and dry. Why does this happen? Clearly it’s because effluvia have come off from them inside of us as well, from which it is clear that what is present in our intestines is also nourishment.”

οἱ γ(ὰρ) προθυμίᾳ γ(ινόμενοι) πρὸς τὸ διαχωρῆσαι,
καταλαμβανόμενοι δὲ ἐν ἀγορᾶι ἢ
ἐν ἀνεπιτηδείοις, εἶτα συσχόν-
τες ἐπὶ πλεῖον, οὐκέτι διαχωρο(ῦσιν)
ἢ διαχωροῦσιν ἐλάχιστά τε καὶ ξηρ(ά).
τίνος αἰ(τίας) γι(νομένης); δῆλον ὅτι ἀποφορᾶς καὶ ἐ̣ν(τὸς)
ἀπ' αὐτ(ῶν) γεγενημέν(ης). ἐξ ὧν φανερόν,
ὡς τροφή (ἐστιν) καὶ ἡ ἐν ἐντέροις παρακειμένη.

Anonymus Londinensis, Fragment 1,1–9 Diels

Thanks to Peter, Ralph and David for pointing these out.

Mardi Gras with Galen: a recipe for ancient Roman pancakes

Here’s a recipe (well, sort of) and description of how pancakes were cooked in ancient Rome. Some things to note: Galen points out the word for ‘pancake’ is pronounced differently by Attic and Asiatic Greek speakers, where the α and the η are switched: ταγηνῖται (tagenitai) vs. τηγανῖται (teganitai). The word for ‘pan’, τάγηνον (tagenon), doesn’t seem to undergo this vowel shift. It is cognate with tajine, but a tajine is more like the ancient kribanos, which Galen mentions in relation to the more common kind of cake, itrion (ἴτριον), known as libum in Latin (a nice recipe here; I like this how-to video). Galen associates these cakes with country people and very poor city people who he tells us make their bread out of whatever they have around. I also think it is interesting how long it takes Galen to describe something as familiar (at least to a North American) as flipping a pancake. Flipping a cake must not have been a very common thing to do (I suppose it still isn’t something one does to most cakes).

“Now would be a good time to talk about all those other cakes that they make from wheat flour. The ones called tagenitai [pancakes] by the Attic speakers but teganitai by us Greek speakers in Asia are prepared solely with olive oil. The oil is placed in a pan that is set on a smokeless fire and once it’s hot wheat flour that’s been mixed with lots of water is poured onto it. After it has cooked for a short time in the oil, it sets and thickens like soft cheese solidifying in baskets. At this point the cooks turn it round, bringing the upper side underneath so that it comes into contact with the pan and turning the side that used to be underneath and is sufficiently cooked so that it becomes the top; once the side underneath has set, they turn it round again two or three times until they think it has been cooked through.

“Now, it’s clear that this is thick-humoured, able to block the stomach, and productive of raw humours. That’s why some people mix honey with it and others sea salt as well. This would be a “kind” or “type” (or whatever your want to call it) of flat-cake, like many other such types of flat-cakes made from whatever’s at hand by country people and very poor people in the city. Likewise all those unleavened cakes they bake in a kribanos then remove and put immediately into warm honey so that it soaks them through, these too are a kind of flat-cake, as are all dishes prepared from cakes with honey.”

Περὶ δὲ τῶν ἄλλων πεμμάτων, ὅσα σκευάζουσιν ἐξ ἀλεύρου πυρίνου, καιρὸς ἂν εἴη λέγειν. οἱ μὲν οὖν ταγηνῖται παρὰ τοῖς Ἀττικοῖς ὀνομαζόμενοι, παρ' ἡμῖν δὲ τοῖς κατὰ τὴν Ἀσίαν Ἕλλησι τηγανῖται σκευάζονται δι' ἐλαίου μόνου. βάλλεται δὲ τὸ μὲν ἔλαιον εἰς τάγηνον ἐπικείμενον ἀκάπνῳ πυρί, καταχεῖται δ' αὐτῷ θερμανθέντι τὸ τῶν πυρῶν ἄλευρον ὕδατι δεδευμένον πολλῷ. διὰ ταχέων οὖν ἑψόμενον ἐν τῷ ἐλαίῳ συνίσταται καὶ παχύνεται παραπλησίως ἁπαλῷ τυρῷ τῷ κατὰ τοὺς ταλάρους πηγνυμένῳ. τηνικαῦτα δ' ἤδη καὶ στρέφουσιν οἱ σκευάζοντες αὐτό, τὴν μὲν ἄνωθεν ἐπιφάνειαν ἐργαζόμενοι κάτωθεν, ὡς ὁμιλεῖν τῷ ταγήνῳ, τὸ δ' αὐτάρκως ἡψημένον, ὃ κάτωθεν ἦν πρότερον, εἰς ὕψος ἀνάγοντες, ὡς ἐπιπολῆς εἶναι, κἀπειδὰν ἤδη καὶ τὸ κάτω παγῇ, στρέφουσιν αὖθις αὐτὸ δίς που καὶ τρίς, ἄχριπερ ἂν ὅλον ὁμαλῶς αὐτοῖς ἡψῆσθαι δόξῃ.

εὔδηλον οὖν, ὅτι παχύχυμόν τε τοῦτ' ἐστὶ καὶ σταλτικὸν γαστρὸς καὶ χυμῶν ὠμῶν γεννητικόν. διὸ καί τινες αὐτῷ μιγνύουσι μέλιτος, εἰσὶ δ' οἳ καὶ τῶν θαλαττίων ἁλῶν. εἴη δ' ἂν ἤδη τοῦτό γε πλακοῦντός τι γένος ἢ εἶδος ἢ ὅπως ἂν ὀνομάζειν ἐθέλῃς, ὥσπερ καὶ ἄλλα πολλὰ τοιαῦτα πλακούντων εἴδη συντιθέασιν αὐτοσχεδίως οἵ τε κατ' ἀγρὸν ἄνθρωποι καὶ τῶν κατὰ πόλιν οἱ πενέστατοι. τοιγαροῦν καὶ ὅσα διὰ κριβάνου τῶν ἀζύμων πεμμάτων ὀπτῶσιν, εἶτ' ἀφελόντες ἐμβάλλουσιν εὐθέως εἰς μέλι θερμόν, ὡς δέξασθαι δι' ὅλων ἑαυτῶν αὐτό, καὶ ταῦτα πλακοῦντός τι γένος ἐστὶ καὶ τὰ διὰ τῶν ἰτρίων σκευαζόμενα μετὰ μέλιτος πάντα.

Galen, On the Capacities of Foods 1.3 (6.490–492 K.)

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Update 22 February 2021

My nieces (with my sister’s help) decided to try out Galen’s recipe along with some traditional pancakes. They used some very light olive oil and some locally milled whole wheat flour. Here’s a quick video.

Galen's advice on how to never get sick ("read my books and pay attention")

"After I turned 28, I had convinced myself that there exists an art of hygiene and I followed its precepts the whole rest of my life. The result was that I never got sick except for the occasional ephemeral fever; but, surely it is possible for someone to preserve themselves completely if they have secured a life of freedom.* This already became clear in the previous sections, and it will become even clearer in the sections that follow should you choose to pay attention. For I say no buboes** can be produced in anyone who has rigorously prepared for health, simply if their body is free from of each kind of excess residue, both in quantity and quality."

ἀλλὰ μετά γε τὸ εἰκοστὸν ὄγδοον ἔτος ἀπὸ γενετῆς ἐμαυτὸν πείσας, ὡς ἔστι τις ὑγιεινὴ τέχνη, τοῖς προστάγμασιν αὐτῆς ἠκολούθησα παρ' ὅλον τὸν ἑξῆς βίον, ὡς μηκέτι νοσῆσαι νόσημα μηδέν, ὅτι μὴ σπάνιόν που πυρετὸν ἐφήμερον. ἔστι δὲ δήπου καὶ τοῦτον αὐτὸν φυλάξασθαι τελέως, ἐλεύθερον ἑλόμενον βίον, ὡς ἔν τε τοῖς ἔμπροσθεν ἤδη γέγονε δῆλον ἔτι τε μᾶλλον ἔσται σαφὲς ἐν τοῖς ἐφεξῆς εἰρησομένοις, εἰ θέλοι τις προσέχειν τὸν νοῦν. ἐγὼ γάρ φημι μηδὲ βουβῶνα δύνασθαι γενέσθαι τοῖς ἀκριβῶς παρεσκευασμένοις εἰς ὑγείαν, εἴ γ' ἀπέριττον αὐτοῖς ἐστι τὸ σῶμα τοῦ γένους τῶν περιττωμάτων ἑκατέρου, τοῦ τε κατὰ τὸ ποσὸν καὶ τοῦ κατὰ τὸ ποιόν.

Galen, De sanitate tuenda, 5.1, 6.309-10 Kühn

*Galen is referring to something he said a bit earlier: that he gets an occasional fever because sometimes he works too much. In other words, he is not free, since he is dedicated to his practice. If you are free, all the more reason you should remain healthy if you follow his advice.

**not quite sure why Galen is singling out buboes here.